Physical Problems Research Articles

Effect of aerobic and resistive exercise on lipid profile and quality of life in overweight breastfeeding women: A randomized controlled trial.

Breastfeeding provides benefits for both mothers and babies. However, many women experience postpartum weight gain, unfavorable lipid profiles, and other postpartum problems that can adversely impact their overall quality of life (QoL). To examine the effect of adding aerobic and resistive exercise to faradic stimulation and nutritional counseling on lipid profile and QoL in overweight breastfeeding women. Fifty-four breastfeeding women were randomly allocated into two equally sized groups. Group A underwent abdominal faradic stimulation along with nutritional counseling for 12weeks, whereas Group B received identical faradic stimulation and nutritional counseling and engaged in a combined aerobic and resistive exercise program for the same duration. Before and after treatment, the following anthropometric measurements were evaluated: body mass index (BMI), waist-to-hip ratio (W/H); lipid profile analysis, such as high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides (TG); and the Short Form 36 Health Survey Questionnaire (SF-36). All outcome measures demonstrated significant improvements within the two groups (p<0.05). Group B showed more significant reductions in BMI, W/H ratio, and LDL, along with greater significant increases in the SF-36 domain scores for physical functioning, physical health problems, bodily pain, general health, energy/fatigue, social activity, mental health, and the total SF-36 score (p<0.05) compared to group A post-treatment. However, there were no significant differences in HDL, TG, and the score of the emotional wellbeing domain of the SF-36 between the groups after treatment (p>0.05). 12-week aerobic and resistive exercise is effective in reducing the BMI, W/H ratio, and LDL levels and enhancing the QoL in overweight breastfeeding women.

Childhood adversity, accelerated GrimAge, and associated health consequences.

Childhood adversity is linked to psychological, behavioral, and physical health problems, including obesity and cardiometabolic disease. Epigenetic alterations are one pathway through which the effects of early life stress and adversity might persist into adulthood. Epigenetic mechanisms have also been proposed to explain why cardiometabolic health can vary greatly between individuals with similar Body Mass Index (BMIs). We evaluated two independent cross-sectional cohorts of adults without known medical illness, one of which explicitly recruited individuals with early life stress (ELS) and control participants (n = 195), and the other a general community sample (n = 477). In these cohorts, we examine associations between childhood adversity, epigenetic aging, and metabolic health. Childhood adversity was associated with increased GrimAge Acceleration (GAA) in both cohorts, both utilizing a dichotomous yes/no classification (both p < 0.01) as well as a continuous measure using the Childhood Trauma Questionnaire (CTQ) (both p < 0.05). Further investigation demonstrated that CTQ subscales for physical and sexual abuse (both p < 0.05) were associated with increased GAA in both cohorts, whereas physical and emotional neglect were not. In both cohorts, higher CTQ was also associated with higher BMI and increased insulin resistance (both p < 0.05). Finally, we demonstrate a moderating effect of BMI on the relationship between GAA and insulin resistance where GAA correlated with insulin resistance specifically at higher BMIs. These results, which were largely replicated between two independent cohorts, suggest that interactions between epigenetics, obesity, and metabolic health may be important mechanisms through which childhood adversity contributes to long-term physical and metabolic health effects.

Gender-related measurement invariance on the Self-Reporting Questionnaire (SRQ-20) for global mental distress with older adults in Puerto Rico

BackgroundCommon mental disorders (CMD) vary by age, gender, and culture. This study: (1) examined the factor structure of the 20-item Self Reporting Questionnaire (SRQ-20) and (2) explored gender-related measurement invariance in the SRQ’s performance with older adults in Puerto Rico, a U.S. island territory and associate member of the UN Regional Commissions.MethodsWe merged data from two cross-sectional studies on mental health status and needs of older adults in Puerto Rico (N = 367). The first study was conducted in 2019, two years after Hurricane María devastated the island (N = 154); the second study, in 2021, assessed knowledge, attitudes and practices (KAP) concerning COVID-19 (N = 213). We used chi-square and t-tests to examine gender differences in each SRQ item and assessed internal consistency reliability with Cronbach’s alpha and McDonald’s omega (values > 0.70). We ran two CFA models, then multigroup CFA to test for gender-related measurement invariance. We used weighted least square mean and variance adjusted (WLSMV) estimation to account for the binary response options in the SRQ-20 and Mplus version 8.4 for analyses. There were no missing data for any SRQ-20 items.ResultsThe SRQ-20 had strong internal consistency reliability (α = 0.89; omega = 0.89). Female scores were higher than males scores (t = -2.159, p = .031). Both unidimensional and two-factor models fit the data well. We selected the more parsimonious unidimensional model, which is most widely used in practice. Standardized factor loadings were 0.548 to 0.823 and all were statistically significant (p < .001). We tested gender invariance with the one-factor model. Our findings did not support invariance.ConclusionWe favored the unidimensional model. First, the SRQ-20 was designed to assess global distress. Also, physical symptoms have both somatic and psychological components, so their co-occurrence makes a single-factor model more meaningful. Finally, since older adults experience more physical health problems, instruments that emphasize both types of distress may provide a more accurate measure than those that exclude somatic symptoms. Using the unidimensional model, the SRQ-20 was not invariant, meaning that it performed differently for male and female participants. Future studies of common mental disorders with older adults in Puerto Rico should consider using the SRQ-20 for research and practice and should determine appropriate threshold scores for men and women.

AHKASH: a new Hybrid particle-in-cell code for simulations of astrophysical collisionless plasma

Abstract We introduce Astrophysical Hybrid-Kinetic simulations with the flASH code ($\texttt {AHKASH}$) – a new Hybrid particle-in-cell (PIC) code developed within the framework of the multi-physics code FLASH. The new code uses a second-order accurate Boris integrator and a predictor-predictor-corrector algorithm for advancing the Hybrid-kinetic equations, using the constraint transport method to ensure that magnetic fields are divergence-free. The code supports various interpolation schemes between the particles and grid cells, with post-interpolation smoothing to reduce finite particle noise. We further implement a δf method to study instabilities in weakly collisional plasmas. The new code is tested on standard physical problems such as the motion of charged particles in uniform and spatially varying magnetic fields, the propagation of Alfvén and whistler waves, and Landau damping of ion acoustic waves. We test different interpolation kernels and demonstrate the necessity of performing post-interpolation smoothing. We couple the TurbGen turbulence driving module to the new Hybrid PIC code, allowing us to test the code on the highly complex physical problem of the turbulent dynamo. To investigate steady-state turbulence with a fixed sonic Mach number, it is important to maintain isothermal plasma conditions. Therefore, we introduce a novel cooling method for Hybrid PIC codes and provide tests and calibrations of this method to keep the plasma isothermal. We describe and test the ‘hybrid precision’ method, which significantly reduces (by a factor ∼1.5) the computational cost, without compromising the accuracy of the numerical solutions. Finally, we test the parallel scalability of the new code, showing excellent scaling up to 10,000 cores.

Impact of gynecological cancers on women’s mental health

Gynecological cancers and their treatments are associated with both specific and non-specific long-term physiological effects. Cancer patients face transformations in their lifestyle, body image, role, and social interactions and suffer from physical, psychological, and economic problems. The mental health of cancer patients is of great importance and requires special attention, as growing evidence demonstrates its influence not only on quality of life but also on treatment compliance. Gynecological cancers have peculiar psychological consequences, which are linked to the specificity of the site of the neoplasia. Clinicians should be aware of the importance of protecting the psychophysical health of these patients and the fact that their physical health and quality of life also depend on the quality of their mental health. It is possible to structure targeted and effective prevention interventions and treatments to reduce psychological distress and improve the quality of life of subjects living with gynecological cancers.

Engagement, Acceptability, and Effectiveness of the Self-Care and Coach-Supported Versions of the Vira Digital Behavior Change Platform Among Young Adults at Risk for Depression and Obesity: Pilot Randomized Controlled Trial

Background Adolescence and early adulthood are pivotal stages for the onset of mental health disorders and the development of health behaviors. Digital behavioral activation interventions, with or without coaching support, hold promise for addressing risk factors for both mental and physical health problems by offering scalable approaches to expand access to evidence-based mental health support. Objective This 2-arm pilot randomized controlled trial evaluated 2 versions of a digital behavioral health product, Vira (Ksana Health Inc), for their feasibility, acceptability, and preliminary effectiveness in improving mental health in young adults with depressive symptoms and obesity risk factors. Methods A total of 73 participants recruited throughout the United States were randomly assigned to use Vira either as a self-guided product (Vira Self-Care) or with support from a health coach (Vira+Coaching) for 12 weeks. The Vira smartphone app used passive sensing of behavioral data related to mental health and obesity risk factors (ie, activity, sleep, mobility, and language patterns) and offered users personalized insights into patterns of behavior associated with their daily mood. Participants completed self-reported outcome measures at baseline and follow-up (12 weeks). All study procedures were completed via digital communications. Results Both versions of Vira showed strong user engagement, acceptability, and evidence of effectiveness in improving mental health and stress. However, users receiving coaching exhibited more sustained engagement with the platform and reported greater reductions in depression (Cohen d=0.45, 95% CI 0.10-0.82) and anxiety (Cohen d=0.50, 95% CI 0.13-0.86) compared to self-care users. Both interventions also resulted in reduced stress (Vira+Coaching: Cohen d=–1.05, 95% CI –1.57 to –-0.50; Vira Self-Care: Cohen d=–0.78, 95% CI –1.33 to –0.23) and were perceived as useful and easy to use. Coached users also reported reductions in sleep-related impairment (Cohen d=–0.51, 95% CI –1.00 to –0.01). Moreover, participants increased their motivation for and confidence in making behavioral changes, with greater improvements in confidence among coached users. Conclusions An app-based intervention using passive mobile sensing to track behavior and deliver personalized insights into behavior-mood associations demonstrated feasibility, acceptability, and preliminary effectiveness for reducing depressive symptoms and other mental health problems in young adults. Future directions include (1) optimizing the interventions, (2) conducting a fully powered trial that includes an active control condition, and (3) testing mediators and moderators of outcome effects. Trial Registration ClinicalTrials.gov NCT05638516; https://clinicaltrials.gov/study/NCT05638516

David vs. Goliath: comparing conventional machine learning and a large language model for assessing students' concept use in a physics problem

Large language models have been shown to excel in many different tasks across disciplines and research sites. They provide novel opportunities to enhance educational research and instruction in different ways such as assessment. However, these methods have also been shown to have fundamental limitations. These relate, among others, to hallucinating knowledge, explainability of model decisions, and resource expenditure. As such, more conventional machine learning algorithms might be more convenient for specific research problems because they allow researchers more control over their research. Yet, the circumstances in which either conventional machine learning or large language models are preferable choices are not well understood. This study seeks to answer the question to what extent either conventional machine learning algorithms or a recently advanced large language model performs better in assessing students' concept use in a physics problem-solving task. We found that conventional machine learning algorithms in combination outperformed the large language model. Model decisions were then analyzed via closer examination of the models' classifications. We conclude that in specific contexts, conventional machine learning can supplement large language models, especially when labeled data is available.

Self-Reported Health and Associated Factors among Nepalese Older Adults

Background: Self-reported health (SRH) is a subjective measurement tool for overall health status that integrates biological, social, mental, and functional aspects of individuals. Objectives: The purpose of this article is to assess the SRH and its correlates among community-living older adults. Methods: This study is a secondary analysis of structured interview data collected by the Central Department of Population Studies at Tribhuvan University (TU) via a cross-sectional survey of community-dwelling persons aged 60+ in the Pharping area of Kathmandu. For this study, there were 1320 valid responses. A simple and direct question was used “In general, how do you rate your general health?” Its answer was recorded on the 5-point Likert scale ranging from “Very Good to Very Bad”. Results: The mean age of the participants was 69.92 years. Of the participants, 19.2% reported poor SRH. Results show mental health problems, total number of children still alive, age of respondent, literacy status, physical health problem now, satisfaction with current living arrangements, walking efficiency, adequate income sources, marital status and currently working were correlated with SRH. However, linear regression shows that significant factors of SRH are walking efficiency (β= 0.324, 95% CI= 0.240 to 0.323), physical health problems (β = -0.258, 95% CI= -0.493 to -0.346), currently working (β: 0.197, 95% CI=0.223 to 0.373), having enough income to meet basic needs (β: 0.065, 95% CI= -0.136 to -0.021) and satisfied with living arrangements (β= 0.065, 95% CI= 0.018 to 0.116). Conclusion: Nepal is aging rapidly, and the proportion of older people will increase in the coming days. Walking efficiency, physical health, currently working and having sufficient income are important factors related to SRH. Identifying these determinants through self-rated status can support the planning of actions aimed at improving the health of the community living older adults.

Organizational ethical pressure as a threat to employee health: The buffering roles of ethical leadership and employee ethical efficacy

AbstractCompetitive pressures, resource constraints, high shareholder/stakeholder expectations, and other dynamics may lead to organizations putting pressure on employees to act unethically to meet goals. Yet, the effects of this pressure on employee health and factors that can abate it are unclear. Based on the job demands‐resources model, this study examines whether, how, and when organizational ethical pressure harms employees' psychological and physical health and what factors can buffer its negative effects. According to the findings of a two‐wave lagged data study involving 212 healthcare employees, results show that organizational ethical pressure causes ethical strain in employees, resulting in both psychological and physical health problems, with these effects less pronounced when employees have higher levels of ethical efficacy. An integrated effect was also discovered, in which employees' ethical efficacy increases when led by a more ethical leader, thereby buffering the effect of ethical pressure on ethical strain and health problems. Overall, our research identifies organizational ethical pressure as a significant threat to employee health and provides preliminary approaches to mitigate its effects.

Adverse childhood experiences: A health risk in emerging adulthood.

Adverse Childhood Experiences (ACEs) represent a child's exposure to negative events that are detrimental to their mental and physical health. Despite this, very few studies have focused on the relationship between ACEs and physical health problems, in non-English-speaking populations and in emerging adulthood. Therefore, the objective of this study was to investigate the cumulative and differential impact of ACEs on diverse physical health problems in a Spanish population. Participants were 648 young adults (22% men), between the ages of 18 and 30 (mean age = 21.37, SD = 3.11), who completed the ACE Questionnaire and answered some questions about their health (e.g. asthma, obesity, global health). From the cumulative perspective, ACEs had a significant relationship with global health and asthma. Additionally, the differential approach revealed some specific ACEs related to three out of five health outcomes. Therefore, early detection of ACEs is of paramount importance to reduce their impact.

The exact solution of the Wegner flow equation with the Mielke generator for 3×3 Hermitian matrices

Abstract The Wegner flow equation is a differential equation for a family of Hamiltonians and can be considered as a continuous unitary transformation. In essence, the transformation continuously decouples degrees of freedom and gradually converts the transformed Hamiltonian into the near-diagonal form. The Wegner flow equation has so far been applied to many areas of physics, but mainly in perturbative calculations. However, the exact solutions are known only for the simplest of two-dimensional case and this certainly limits the practical application of the method. On the other hand, the knowledge of exact solutions is essential for many physical problems as well as can help in constructing improved approximated approaches. In this paper we present the exact solution of the Wegner flow equation with the Mielke generator for $3\times 3$ Hermitian matrices, the general solutions for $N\times N$ tridiagonal Hermitian matrices and partially for $4\times 4$ real symmetric matrices.

Quality of Life in Patients Living with Andro-gentic Alopecia: A Cross Sectional Observational Study

Alopecia is a chronic dermatological disorder in which people lose some or all of the hair on their head and sometimes on their body as well. It is a chronic inflammatory disease that affects the hair follicles. It is neither life threatening nor painful, though there can be irritation of the skin, as well as physical problems resulting from the loss of eyelashes and eyebrows.This study aim to improve the quality of life and prescription pattern in androgenic alopecia. The goal of the study was to assess the quality of life of subjects living androgenic alopecia and to assess the prescription pattern of subjects with androgenic alopecia.This was a cross sectional observational study. The study was conducted Outpatient department of Dermatology in ESI MC PGIMSR, Rajajinagar. All the subjects (n=36) meeting the inclusion and exclusion criteria were briefed about the purpose of the study and the informed consent was obtained. The subject’s demographic details and responses were collected with the help of a standardized questionnaire. The collected data were entered in Microsoft Excel and appropriate descriptive analysis was performed. It was observed that a majority of the subjects were prescribed with minoxidil 5% (58.33%). On comparing the QOL scores, in each domain it was found that emotion has the highest average while the function has lowest average. scores in subjects of different age groups, it was found that the subjects belonging to the age groups 26-35 groups had high average scores (32.84%) and 36-45 groups had low average scores (28.96%).From this study, we got to know that the quality of life of male gender is affected more rather than female. Minoxidil 5% was most commonly prescribed drug and overall dosage form prescribed were topical agent.

Recruiting people with selected citizenships for the health interview survey GEDA Fokus throughout Germany: evaluation of recruitment efforts and recommendations for future research

BackgroundGermany is the second most common country of immigration after the US. However, people with own or familial history of migration are not represented proportionately to the population within public health monitoring and reporting. To bridge this data gap and enable differentiated analyses on migration and health, we conducted the health interview survey GEDA Fokus among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship living throughout Germany. The aim of this paper is to evaluate the effects of recruitment efforts regarding participation and sample composition.MethodsData collection for this cross-sectional and multilingual survey took place between 11/2021 and 5/2022 utilizing a sequential mixed-mode design, including self-administered web- and paper-based questionnaires as well as face-to-face and telephone interviews. The gross sample (n = 33436; age range 18–79 years) was randomly drawn from the residents’ registers in 120 primary sampling units based on citizenship. Outcome rates according to the American Association for Public Opinion Research, the sample composition throughout the multistage recruitment process, utilization of survey modes, and questionnaire languages are presented.ResultsOverall, 6038 persons participated, which corresponded to a response rate of 18.4% (range: 13.8% for Turkish citizenship to 23.9% for Syrian citizenship). Home visits accounted for the largest single increase in response. During recruitment, more female, older, as well as participants with lower levels of education and income took part in the survey. People with physical health problems and less favourable health behaviour more often took part in the survey at a later stage, while participants with symptoms of depression or anxiety more often participated early. Utilization of survey modes and questionnaire languages differed by sociodemographic and migration-related characteristics, e.g. participants aged 50 years and above more often used paper- than web-based questionnaires and those with a shorter duration of residence more often used a translated questionnaire.ConclusionMultiple contact attempts, including home visits and different survey languages, as well as offering different modes of survey administration, increased response rates and most likely reduced non-response bias. In order to adequately represent and include the diversifying population in public health monitoring, national public health institutes should tailor survey designs to meet the needs of different population groups considered hard to survey to enable their survey participation.

Changes in health-related quality of life over the first three months of medical marijuana use

BackgroundThe psychosocial impact of medical marijuana use is not yet known. This study evaluated short-term changes in health-related quality of life (HRQoL) over the first three months of medical marijuana use.MethodsThis prospective, observational, longitudinal study followed adults newly recommended for medical marijuana by a physician for any of the more than 20 qualifying medical conditions in Pennsylvania. Participants (N = 438) provided their clinical status and demographic information, and completed semi-structured interviews prior to medical marijuana initiation (baseline) and at three months. HRQoL was assessed by the Short Form-36 (SF-36). Paired-samples t-tests evaluated changes in HRQoL over time.ResultsParticipants (M age = 46.4 years [15.6]; 66.4% female) were mostly commonly referred for medical marijuana to treat anxiety disorders (61.9%) or severe chronic or intractable pain (53.6%). Participants reported rapid and significant improvements in all of the domains of HRQoL from baseline to three months after initiating medical marijuana use (physical functioning, role limitations due to physical health problems, emotional well-being, role limitations due to emotional problems, bodily pain, social functioning, energy/fatigue and general health, P < .001 for all). Age was negatively predictive of level of improvement over time for the physical functioning (P < .0001), role limitations due to physical health problems (P < .001), and pain (P < .0001) domains after controlling for baseline, with older participants displaying less improvement than younger participants.ConclusionsGains were observed in all HRQoL domains assessed after three months of medical marijuana use. In several domains, age was a significant predictor of degree of improvement.

Evaluation of DSM-5 Diagnostic Criteria for Betel-Quid Use Disorder Using the Addiction Characteristics Defined by American Society of Addiction Medicine

Background The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), categorizes betel-quid use disorder (BUD) under Other (Or Unknown) Substance Use Disorder, and the diagnostic criteria used are adapted from those of Substance Use Disorder. Because different substances have different characteristics, an improved set of diagnostic criteria is required to better detect BUD. Objective The objective of this study was to examine the different measures of accuracy for DSM-5 BUD by using the addiction characteristics defined by the American Society of Addiction Medicine (ASAM). Methods A certified psychiatrist conducted face-to-face diagnostic interviews. Questionnaires were administered to assess betel-quid use history, patterns of use, and dependence features. All betel-quid users were evaluated for BUD by using the DSM-5 criteria and addiction characteristics defined by the ASAM. Results One of the DSM-5 diagnostic criteria for BUD, namely large amount of time spent on obtaining and using betel quid and recovering from betel-quid use, showed the lowest sensitivity of 0.14, lowest diagnostic accuracy of 0.63, and lowest diagnostic odds ratio of 2.61. Another DSM-5 diagnostic criterion, namely continued betel-quid use despite knowledge of physical or psychological problems, had the lowest specificity of 0.49. The diagnostic threshold of five or more DSM-5 BUD criteria showed a sensitivity of 0.86 and a specificity of 0.97. Conclusions This study is the first to evaluate the different measures of accuracy for DSM-5 BUD. Given that each addictive substance has unique addictive characteristics, the composition and number of criteria for diagnosing DSM-5 BUD must be reconsidered.

Bangladesh Ship Breaking Industry and Livelihood Assessment of Out-Migrant Workers: A Study of Southern - Northern Region in Bangladesh

Since 1971, the shipbreaking industry in Bangladesh has grown rapidly, employing approximately 40,000 to 50,000 underprivileged workers from the most underdeveloped regions of Bangladesh. After working for 15-20 years, they leave this industry for different sorts of physical problems, which lead to a low quality of life. Therefore, this paper aims to explore the livelihood status of the out-migrant workers in the shipbreaking industry of Bangladesh. The instruments used for this research were a semi-closed-ended survey questionnaire, in-depth interviews, ethnographic participant observation, and secondary research. The respondents are from the southern and northern parts of Bangladesh, aged 18 years and older. This study has discovered no significant differences between northern and southern out-migrant workers in asset ownership, goods, or housing quality. However, the southern out-migrant population earned relatively more than the northern migrants due to better access to capital and institutional support. This study also shows that after working a few years, young people desire to do external migration for better income opportunities. Despite minimal overall improvement in livelihood status, southern migrants earn comparatively better. Therefore, the government and other stakeholders must bridge the gap of unequal socio-economic development between the southern and northern regions.

Oblique wave scattering by a pair of asymmetric inverse Π-shaped breakwater

Abstract The topic of wave scattering by different breakwaters has unfolded over the past few decades, largely driven by the profound impacts of global climate change. In this study, a completely new type of breakwater, inverse Π-shaped breakwater, has been taken into account for serving both purposes from analytical as well as an application point of view. During the formulation, the actual physical problem is transferred into a boundary value problem by employing the small amplitude water wave theory. With the aid of eigenfunction expansion, the problem is reduced to a set of integral equations having square-root singularities at the submerged edges of thin structures. To address such singularities, a multi-term Galerkin approximation technique is used along with Chebyshev polynomials (multiplied with suitable weights) as basis functions. The numerical methodology employed here validates with different previous literatures as special cases. Then, numerical solutions of the reflection and transmission coefficients, hydrodynamic forces are graphically illustrated across various dimensionless structural parameters. In summary, the present paper offers valuable insights into the dynamics of wave scattering by a pair of asymmetric inverse bottom-mounted Π-shaped breakwater, emphasizing the role of different non-dimensional parameters in this system.

Maintaining psychological well-being when living at risk of Huntington's disease: An interpretative phenomenological analysis.

Living at risk of a genetically inherited disease can be a challenging experience causing psychological distress as well as the possibility of the genetic disease leading to physical health problems. Huntington's disease (HD) is a genetic, neurodegenerative condition. It causes motor dysfunction, cognitive decline and, during the progression of the disease, different psychological difficulties are common. A total of 12 participants living at risk of HD were interviewed and interpretative phenomenological analysis methodology was used to understand their experiences of maintaining psychological well-being. This resulted in three themes: (1) "you're constantly in limbo": living in two worlds; (2) "I have to live, just bloody live": managing the possibility of a time-limited lifespan; and (3) "I try and try my hardest to look past the disease": the exhausting quest to keep living well. The findings indicated a need for improved knowledge within professional settings, such as for family doctors, counselors, and other health professionals, specific strategies that genetic counselors can use to support this group, and provision of accessible support and implementation of systemic interventions that would offer support for psychological coping strategies and communication around well-being to the individual and their family unit. Future research could contribute to the formation of such knowledge and the provision of HD-aligned services to help support the psychological well-being of people living at risk of HD.

The Role of Complicated Grief in Health Inequities in American Indian Communities

Complicated grief is both a cause and a consequence of health inequities in Native (American Indian/Alaska Native [AI/AN]) communities. Given disproportionately high rates of physical (e.g., cancer, diabetes, and heart disease) and mental health problems (e.g., substance use disorder, posttraumatic stress disorder) in Native communities, it is common for AI/AN people to suffer many losses each year. Experiences of traumatic or repeated losses may lead to the development of maladaptive grief, often known as complicated grief. The aim of the current study was to understand the perspectives of community members on grief and its connection with health inequities among AI people who have experienced the loss of a person with whom they were close. Using a community-based participatory research framework, we conducted semi-structured interviews with 12 AI adults from a rural reservation community. The ages of the participants ranged from 32 to 80 years ( M = 54.33, SD = 14.46) and women ( n = 7, 58.3%) and men ( n = 5, 41.7%) were included. The participants reported many barriers to healthy grieving and linked chronic, complicated grief with the development of multifaceted health problems, which were seen as exacerbating health disparities and leading to additional losses and grief. While coping with loss was difficult, many people were able to heal from extraordinary losses through community support and cultural practices. Future research with AI/AN communities is needed to develop, implement, and evaluate culturally responsive therapeutic grief treatments. There is also a pressing need to address current physical and mental health inequities to reduce the mortality rate and, thus, complicated grief in AI/AN communities.

Early treatment of Class Ⅲ malocclusion based on craniomaxillofacial growth and development

More and more attention has been paid to the early treatment of malocclusion, especially the early treatment of class Ⅲ malocclusion. Class Ⅲ malocclusion not only affects maxillofacial growth and development, occlusal function and facial beauty, but also leads to serious physical and mental problems. Focusing on class Ⅲ malocclusion, the definition, classification, etiological mechanism, craniofacial growth and development rule, and the influence of early treatment on craniofacial growth and development were reviewed. In class Ⅲ patients, the craniofacial growth and development should be evaluated and analyzed when the early intervention carried out. The purpose of treatment of class Ⅲ malocclusion is achieved by using the appliance to affect the craniomaxillofacial growth.